Caring for the whole student

Melanie Lewis

Advocacy & Wellbeing office is here for academic, mental-health support

By Sasha Roeder Mah

The core philosophy of the Alberta Medical Association is that asking for help is a sign of strength. But cultivating that willingness in physicians to be vulnerable and seek support begins in the Faculty of Medicine & Dentistry.

It's here that the faculty's office of Advocacy & Wellbeing serves a crucial role, says Associate Dean Melanie Lewis. "Our goal is to ensure that students meet their best academic and personal potential, and that we address any barriers that are hampering them."

What is the mandate of a typical learner advocacy office?

It is mandated through accreditation that all MD programs must have an office of student affairs, but only over the past several years have such offices evolved to focus more on student well-being, both physical and mental. "We are unique in that we include postgraduate and graduate learners under one office," says Lewis.

Why is this office important in a medical school?

There's a stigma that persists in the medical profession around asking for help or admitting one is suffering, says Lewis. "You feel like you're less than; you're not as good as or as cool as or as well-adjusted as everyone else; everybody's coping better." And sometimes, in the service of making excellent physicians, student wellness ends up at the bottom of a long list of priorities. She says it's important to build in students the habit of seeking help from the moment they enter school, through clinical placements and residency and beyond.

How does the office collaborate with students?

The Office of Advocacy & Wellbeing's involvement in student wellness initiatives begins during the annual peer-support orientation week, when, together with students, they plan events that, as Lewis says, "introduce a supportive culture in which the students will have each other's backs." It's not just her office that does the heavy lifting around student support: "The students have always been a major advocate at the table to get advocacy and wellness needs met in an official capacity."

How far-reaching is the support offered by the office of Advocacy & Wellbeing?

The office supports students in myriad ways, from information about wellness and financial literacy embedded in the curriculum to individual psychological and career counselling services. "I want students to know that there are multiple doors here with multiple people students can trust that they can go to," including a full-time psychologist and four assistant deans who help with academic appeals, advice to deal with harassment or intimidation and conflict resolution, among other stressors.

"We are a confidential, safe space. Students can come here knowing they can unload whatever they need to," says Lewis, "whether it's addiction issues, or depression, or severe academic peril, and feel safe that this information isn't going to hurt their academic reputation."

What is the most pressing issue facing medical students?

These days, Lewis sees a significant uptick in students seeking career counselling after having been unmatched for the medical residency of their choice. Each year the number of residency positions available for Canadian medical graduates has decreased due to government funding and in 2017, 68 graduating medical students in Canada did not get a match.

At the U of A's medical school, counselling to undergo the match process is embedded as part of the MD curriculum. "With less residency positions available, many students have heightened concerns, especially for students pursuing specialties where the demand substantially outstrips the supply," says Lewis.

The MD program and the Advocacy & Wellbeing office all work together to help students succeed and provide support for each stage of the process. Additional resources include resume reviews and practice interviews for students with faculty and volunteer residents. They help unmatched students broaden their scope of potential specialties and connect them with specialists to shadow.

"If they are still unmatched, we create programs where they can stay as undergraduate students in the MD program and pursue special training in research (MD STIR)
or an MD/MBA program. Students who have pursued that extra year have been very successful in the following match.

"We have a commitment to our students," says Lewis. "We are not going to leave them alone in this journey."

Soft skills for self-help

"I think every aspect of our faculty should be promoting health and well- being," says Pamela Brett-MacLean, Director, Arts & Humanities in Health & Medicine (AHHM) program, and a selection of electives from her program are doing just that. Newest among the offerings is Healer's Art, held here for the first time last spring. The course was designed by Rachel Remen (University of San Francisco) and has since been embraced by medical schools across North America. Healer's Art has proven to be a powerful experience for both facilitators and learners, says Brett-MacLean, a co-lead for the pilot course.

  • With only 20 students per session- five per facilitator for intimate group discussions-Healer's Art provides a safe, non-judgmental space for personal growth and to help students understand the need for both self-care and deep empathy as they pursue their medical school journey. Topics in the seminar include grief and loss, compassion, stress prevention and what it means to truly embrace medicine as a calling.

  • Over the course of eight hours, Introduction to Mindfulness teaches students techniques for stress management, focus and concentration. Students learn how practising mindfulness can improve their communication skills, openness to collaboration and ability to lead through example.

  • In Spirituality and Health, students learn about the significance of spiritual care for some patients, and are asked to delve into the role of spirituality in their own lives and how that will impact the care they provide